Pathological sequelae of long-haul COVID

• Published in: Nature immunology Vol. 23; no. 2; pp. 194 - 202
• Main Authors: Mehandru, Saurabh, Merad, Miriam
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.02.2022; Nature Publishing Group
• Subjects: 631/250/255/2514; 692/699/255/2514; Autoimmunity; Biomedical and Life Sciences; Biomedicine; Complications; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - immunology; COVID-19 - physiopathology; COVID-19 - virology; Dyspnea; Host-Pathogen Interactions; Humans; Immunology; Infectious Diseases; Inflammation; Long COVID; Post-Acute COVID-19 Syndrome; Prognosis; Respiration; Review Article; SARS-CoV-2 - immunology; SARS-CoV-2 - pathogenicity; Symptom Assessment; Time Factors
• ISSN: 1529-2908; 1529-2916; 1529-2916
• DOI: 10.1038/s41590-021-01104-y

The world continues to contend with successive waves of coronavirus disease 2019 (COVID-19), fueled by the emergence of viral variants. At the same time, persistent, prolonged and often debilitating sequelae are increasingly recognized in convalescent individuals, named ‘post-COVID-19 syndrome’ or ‘long-haul COVID’. Clinical symptomatology includes fatigue, malaise, dyspnea, defects in memory and concentration and a variety of neuropsychiatric syndromes as the major manifestations, and several organ systems can be involved. The underlying pathophysiological mechanisms are poorly understood at present. This Review details organ-specific sequelae of post-COVID-19 syndromes and examines the underlying pathophysiological mechanisms available so far, elaborating on persistent inflammation, induced autoimmunity and putative viral reservoirs. Finally, we propose diagnostic strategies to better understand this heterogeneous disorder that continues to afflict millions of people worldwide. It is increasingly obvious that individuals are experiencing post-COVID-19 syndromes, or ‘long-haul COVID’. Here, Merad and Mehandru eview currently available knowledge of the underlying pathophysiological mechanisms of these sequelae, elaborating on persistent inflammation, induced autoimmunity and putative viral reservoirs.